Interchangeable flush/selective catheter

ABSTRACT

A combination flush catheter and selective catheter as one convertible catheter and methods of using the same. The selective catheter may be a reverse curve or guide catheter. The additional steps of removal of the flush catheter and re-insertion of the selective catheter may be eliminated, reducing the possibility of errors and making the procedure smoother and shorter.

CROSS-REFERENCE TO RELATED APPLICATIONS

The application is a divisional of U.S. patent application Ser. No.16/204,478, filed on Nov. 29, 2018, currently pending, which is acontinuation of U.S. patent application Ser. No. 15/225,667, filed Aug.1, 2016, now U.S. Pat. No. 10,173,031, which claims the benefit of andpriority under 35 U.S.C. § 119(e) to U.S. provisional patent applicationNo. 62/352,492, entitled “Interchangeable Flush/Selective Catheter”,filed Jun. 20, 2016, the entirety of which is herein incorporated byreference.

BACKGROUND 1. Field

The invention relates to improved methods for providing easy visibilityand access for aortic catheters to identify the branching locations ofinterest and shortening the time taken for procedures.

2. Related Art

Today's catheters are used for minimally invasive life saving proceduresespecially procedures in the vessels branching off from the mainarteries and or veins. These catheters are inserted percutaneouslythrough the femoral artery or vain and guided through the main vesselunder visual guidance typically using x-ray fluorescence. In order forthe vessels to be visible by x-ray imaging and to identify the locationof branching, etc., it is necessary to bathe the walls of the vessels,both veins and arteries to be flushed with a solution that contains theradiopaque compound. This is done by inserting a first catheter—a flushcatheter having holes in the side wall that is used to spray theradiopaque compound on to the arterial or venous walls thereby makingthem visible in the x-ray fluoroscope. This action also helps toidentify the openings and origins of vessels branching off ororiginating from the main vessel. Once the branch or vessel ofimportance is identified, the flush catheter is removed and a selectivecatheter such as a guide catheter/or reverse curve catheter is insertedpercutaneously to access the identified opening of the vessel where theprocedure is needed or the branch vessel. This requires an accuratejudgment of the location of the opening from the main vessel to thevessel where the procedure is to be performed. This dual operationintroduces complexity of an additional catheter introduction and alsocould result in problems of guiding the guide/or reverse curve catheterinto the location of the procedure as the radiopaque contrast agentwould have dissipated by the time the second catheter is introduced andguided to the location.

SUMMARY

The following summary of the invention is included in order to provide abasic understanding of some aspects and features of the invention. Thissummary is not an extensive overview of the invention and as such it isnot intended to particularly identify key or critical elements of theinvention or to delineate the scope of the invention. Its sole purposeis to present some concepts of the invention in a simplified form as aprelude to the more detailed description that is presented below.

Embodiments of the invention relate to the capability to introduce asingle selective catheter that can initially work as a flush catheterbut can be converted to a guide/or reverse curve catheter once theprocess vessel is identified. This reduces the complexity of theprocedure, reduces the time required for the procedure and reduces theerrors in selection of the appropriate vessel that requires correctiveprocedure performed.

In accordance with one aspect of the invention, the use of a convertiblecatheter is disclosed that can act as a flush catheter and then convertto a selective catheter such as a reverse curve/guide catheter.

In accordance with one aspect of the invention, the structure of theflush/selective catheter is disclosed.

In accordance with one aspect of the invention, the ease of use of thedisclosed catheter to identify the branches of interest and using thesame as the converted selective catheter to access the site of theprocedure is disclosed.

In accordance with one aspect of the invention, the capability of theinterchangeable flush/selective catheter to reduce errors and mistakesand reduce the time taken for the procedure is disclosed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated into and constitute apart of this specification, illustrate one or more examples ofembodiments and, together with the description of example embodiments,serve to explain the principles and implementations of the embodiments.

FIG. 1 is an exemplary diagrammatic representation of an interchangeableflush/selective catheter with the flush catheter holes in the closedcondition in accordance with one embodiment of the invention.

FIG. 1A is a diagrammatic representation of the catheter of FIG. 1 withthe flush holes in the open flushing condition in accordance with oneembodiment of the invention.

FIG. 1B is a diagrammatic representation of the catheter in FIG. 1 witha Tuohy Bost adapter attached to the base catheter and showing the useof an occluding mechanism for the catheter in accordance with oneembodiment of the invention.

FIG. 2 is an exemplary diagrammatic representation of an interchangeableflush/selective catheter with the flush holes in open position inaccordance with one embodiment of the invention.

FIG. 2A is a diagrammatic representation of the catheter of FIG. 2 withthe flush holes in the closed position in accordance with one embodimentof the invention.

FIG. 3 is an exemplary diagrammatic representation of an interchangeableflush/selective catheter with the flush holes in a closed position inaccordance with one embodiment of the invention.

FIG. 3A is a diagrammatic representation of the catheter of FIG. 3 withthe flush holes in an open position in accordance with one embodiment ofthe invention.

DETAILED DESCRIPTION

Embodiments of the invention combine a flush catheter and a selectivecatheter, such as the reverse curve or guide catheter, as oneconvertible catheter. The additional steps of removal of the flushcatheter and re-insertion of the selective catheter, such as reversecurve or guide catheter, is eliminated, reducing the possibility oferrors and making the procedure smoother and shorter.

FIG. 1 is a diagrammatic representation of a first embodiment of theinterchangeable flush/selective catheter 100 in the closed position asper a first embodiment of the invention with the flush catheter holes104A on the outer catheter 101 misaligned with the holes 104B in theinner catheter 102 so as to place the flush/selective catheter 100 inthe closed condition, that is the catheter is in an end holeangiographic catheter mode through the open end 103 of the innercatheter 102. FIG. 1A is a diagrammatic representation 100A of theflush/selective catheter 100 of FIG. 1 with the flush holes 104A and104B in the aligned open flushing condition that is the flush/selectivecatheter 100 is in a multi-side-hole flush catheter mode. The changefrom a flush catheter mode to the end hole mode is done by twisting theinner catheter 102 with reference to the outer catheter 101. It is doneby using the connector 106 connected to the outer catheter 101 and thetwist connector 107 connected to the inner catheter 102. By twisting thetwist connector 107 the flush/selective catheter can be made into anend-hole configuration or a flush catheter configuration.

FIG. 1B shows the flush/selective catheter 100 implementation 100B withexternal connections through a Tuchy-Borst adaptor 110 having twoconnections 108 and 109 for connection to the inner and outer catheters102 and 101 respectively. Use of the Tuchy-Borst adapter helps toprovide reliable connection to the two catheters 102 and 101. Furtherthe implementation includes an occluding tip 112 of occluding tip wire111 which is used to close the open tip 103 of the inner catheter 102when flush/selective catheter 100B is used as a flush catheter. Theoccluding tip wire may be removed when the catheter needs to serve as aselective catheter. The side-holes of the two coaxial catheters aremisaligned during this time for conversion to selective catheter.

FIG. 2 is a different embodiment of the flush/selective catheter 200.The implementation shown in 200 has an inner catheter 202 connected to apull knob 209 and an outer catheter 201 that is close fitting over theinner catheter 202 and is connected to a hold knob 206. Both cathetershave holes 204A and 204B, vertically aligned. These holes line up toconfigure the flush/selective catheter 200 into flush mode by pullingdown on the knob 207 as shown in FIG. 200. An iris 205 in the outercatheter 201 is closed when the flush/selective catheter 200 is in theflush catheter configuration. FIG. 2A is a representation 200A of theflush/selective catheter 200 with the holes 204A and 204B miss-alignedfor the flush/selective catheter 200 to be configured as a end holecatheter 200 A. When the flush/selective catheter is in the end-holecatheter mode as shown in FIG. 2A the end of the inner catheter 202pushes through the iris 205 to open the inner catheter end 203 into theouter catheter 201.

FIG. 3 is a third embodiment 300 of the flush/selective catheter. FIG. 3shows the flush/selective catheter having an inner catheter 202 withoutany holes inside an outer catheter 301. The outer catheter 301 has holes304A close to its distal end for providing the flush capability. Theouter catheter is connected to a hold knob 306 and the inner catheter isconnected to a pull knob 307. There is an iris 312 at a region withinthe outer catheter 30 that is closer to the distal end of the catheterthan the holes 304A. When the flush/selective catheter is in the endhole catheter configuration, the pull knob 307 is flush with the holdknob 306 which pushes the inner catheter 302 up through the iris 312 andopens up the end 303 of the inner catheter 302 into the outer catheter301. Since the inner catheter 302 has no holes the inner catheter blocksoff the holes 304A of the outer catheter 301 preventing any flushaction. FIG. 3A shows the flush/selective catheter 300 in the flushconfiguration 300A. To put the flush/select catheter in this mode thepull knob 307 is pulled out so that the end of the inner catheter 302 ispulled through the iris 312 allowing the iris to close blocking theflush/selective catheter 300A from being an end hole catheter. Furtherthe inner catheter end 303 is pulled down below the level of the holes304A in the outer catheter 301, to open the holes 304A. This allows theconfigured flush/selective catheter 300A to act as a flush catheter.

As will be understood by those familiar with the art, the invention maybe embodied in other specific forms without departing from the spirit oressential characteristics thereof. Likewise, the particular naming anddivision of the members, features, attributes, and other aspects are notmandatory or significant, and the mechanisms that implement theinvention or its features may have different structural construct,names, and divisions. Accordingly, the disclosure of the invention isintended to be illustrative, but not limiting, of the scope of theinvention.

While the invention has been described in terms of several embodiments,those of ordinary skill in the art will recognize that the invention isnot limited to the embodiments described, but can be practiced withmodification and alteration within the spirit and scope of the appendedclaims. The description is thus to be regarded as illustrative insteadof limiting. There are numerous other variations to different aspects ofthe invention described above, which in the interest of conciseness havenot been provided in detail. Accordingly, other embodiments are withinthe scope of the claims.

The invention has been described in relation to particular examples,which are intended in all respects to be illustrative rather thanrestrictive. Those skilled in the art will appreciate that manydifferent combinations will be suitable for practicing the presentinvention. Other implementations of the invention will be apparent tothose skilled in the art from consideration of the specification andpractice of the invention disclosed herein. Various aspects and/orcomponents of the described embodiments may be used singly or in anycombination. It is intended that the specification and examples beconsidered as exemplary only, with a true scope and spirit of theinvention being indicated by the following claims.

What is claimed is:
 1. A convertible catheter comprising: an outercatheter comprising a distal end, a proximal end, and at least one sidetherebetween, wherein the outer catheter comprises at least one flushhole on the at least one side closer to the distal end than the proximalend; an inner catheter comprising an open distal end, a proximal end,and at least one side therebetween, wherein the inner catheter isslidably within the outer catheter, wherein the inner catheter comprisesat least one flush hole on the at least one side closer to the distalend than the proximal end; a closure device configured to close theinner catheter, wherein the closure device is located closer to thedistal end of the inner catheter than the at least one flush hole of theinner catheter; an adapter coupled to the outer catheter and the innercatheter, wherein the adapter comprises a first connector connected tothe outer catheter and a second connector connected to the innercatheter, wherein the second connector is rotatable with respect to thefirst connector to slidably rotate and move the inner catheter withinthe outer catheter; wherein the convertible catheter is configurable asa flush catheter when the inner catheter is slidably rotated and movedto align the at least one flush hole of the inner catheter with the atleast one flush hole of the outer catheter and the closure device closesthe distal end of the inner catheter; and wherein the convertiblecatheter is configurable as a selective catheter when the inner catheteris slidably rotated and moved to misalign the at least one flush hole ofthe inner catheter with respect to the at least one flush hole of theouter catheter and the closure device opens the distal end of the innercatheter.
 2. The convertible catheter of claim 1, wherein the closuredevice comprises an occluding tip, wherein the occluding tip isconnected to a tip wire to enable opening and closing of the innercatheter.
 3. The convertible catheter of claim 1, wherein the innercatheter is a reverse curve catheter.
 4. The convertible catheter ofclaim 1, wherein the inner catheter is a guide catheter.
 5. Theconvertible catheter of claim 1, wherein the inner catheter comprises atleast one flush hole and an occluding tip as the closure device.
 6. Theconvertible catheter of claim 5, wherein the convertible catheter isconfigured to be used as a flush catheter when the at least one flushhole in the outer catheter is aligned with the at least one flush holein the inner catheter and an occluding tip closes the open tip of theinner catheter. The convertible catheter of claim 1, wherein the closuredevice comprises an iris.
 8. A convertible catheter, configurable as aselective catheter or a flush catheter, the convertible cathetercomprising: an outer catheter comprising a distal end, a proximal end,and at least one side therebetween, wherein the outer catheter comprisesat least one flush hole on the at least one side closer to the distalend than the proximal end; the outer catheter further comprising aclosure device, near the distal end, distal to the at least one flushhole; an inner catheter comprising an open distal end, a proximal end,and at least one side therebetween, wherein the inner catheter slideablyfits within the outer catheter; the closure device configured to openwhen the inner catheter is pushed through the closure device, exposingthe open distal end of the inner catheter; an adapter coupled to theouter catheter and the inner catheter, wherein the adapter comprises afirst connector connected to the outer catheter and a second connectorconnected to the inner catheter, wherein the second connector is movablerelative to the first connector to slideably move the inner catheterwithin the outer catheter; wherein the convertible catheter isconfigurable as a flush catheter when the inner catheter is slideablymoved to expose the at least one flush hole of the outer catheter andthe closure device closes the distal end of the inner catheter; andwherein the convertible catheter is configurable as a selective catheterwhen the inner catheter is slideably moved to push through and open theclosure device with the at least one flush hole of the outer catheterclosed by the at least one side of the inner catheter.
 9. Theconvertible catheter of claim 8, wherein the closure device is an iris.10. The convertible catheter of claim 9, wherein the open distal end ofthe inner catheter is proximal to the at least one flush hole on the atleast one side of the outer catheter when the convertible catheter isconfigured as a flush catheter.
 11. The convertible catheter of claim 9,wherein the open distal end of the inner catheter is pushed up throughthe closure device when the convertible catheter is configured as aselective catheter.
 12. A method of converting the configurableconverter of claim 1 as a flush catheter, the method comprising:slideably rotating and moving the inner catheter to align the at leastone flush hole of the inner catheter and the at least one flush hole ofthe outer catheter; and closing the distal end of the inner catheterusing the closure device.
 13. A method of converting the configurableconverter of claim 1 as a selective catheter, the method comprising:slideably rotating and moving the inner catheter to misalign the atleast one flush hole of the inner catheter with the at least one flushhole of the outer catheter; and opening the distal end of the innercatheter.
 14. A method of converting the configurable converter of claim8 as a flush catheter, the method comprising: slideably moving the innercatheter expose the at least one flush hole; and closing the distal endof the other catheter using the closure device.
 15. A method ofconverting the configurable converter of claim 8 as a selectivecatheter, the method comprising: slideably moving the inner catheter toclose the at least one flush hole.
 16. The method of claim 15, furthercomprising: pushing the inner catheter to open the closure device.